| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,096 |
1,051 |
$101K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
612 |
582 |
$70K |
| V2020 |
Frames, purchases |
2,239 |
2,085 |
$70K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,438 |
1,334 |
$55K |
| 92015 |
Determination of refractive state |
2,893 |
2,677 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,168 |
2,020 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
334 |
327 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
212 |
202 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
435 |
415 |
$4K |
| 92002 |
|
51 |
50 |
$3K |
| 2026F |
|
264 |
235 |
$0.00 |
| 2033F |
|
1,041 |
1,005 |
$0.00 |